Warthin tumor: A new hypothesis concerning its development

https://doi.org/10.1016/S1079-2104(98)90399-7Get rights and content

Abstract

Objective. Warthin tumor is the second most common benign parenchymal salivary neoplasm. The purpose of this study was to evaluate the histopathologic features of Warthin tumor to determine whether a developmental pattern could be identified.

Study design. Seventy-nine Warthin tumors in 63 patients (62 male and 1 female; average age, 58.62 years) were examined. All cases were histopathologically classified and morphometrically analyzed with an Optomax system to measure the proportions of lymphoid tissue and cystic cavities.

Results. The predominantly epithelial type (21% of all cases) of Warthin tumor was associated with a mean patient age at diagnosis of 53 years, a mean evolution time of 2.8 months, an average size of 1 cm, and a mean lymphoid component of 10%. In the case of the classical type (61% of all cases), the mean patient age at diagnosis was 58 years, the mean evolution time 9 months, the average size 2.4 cm, and the mean lymphoid component 40%. For the predominantly lymphoid type (18% of all cases), these values were, respectively, 62 years, 11 months, 2.8 cm, and 74%. The mean size of the classical and lymphoid tumors (79% of the Warthin tumors) was significantly greater (p < 0.0001) than the mean size of the epithelial type (21% of the Warthin tumors). A positive correlation between tumor size and evolution time was found.

Conclusion. Our results suggest that the Warthin tumor initially develops as an adenomatous epithelial proliferation followed by lymphocytic infiltration.

References (18)

There are more references available in the full text version of this article.

Cited by (44)

  • Salivary Glands

    2020, Gnepp's Diagnostic Surgical Pathology of the Head and Neck, Third Edition
  • Diagnostic pitfalls of infarcted Warthin tumor in frozen section evaluation

    2016, Annals of Diagnostic Pathology
    Citation Excerpt :

    In the early literature, WT was reported to have a distinct male predilection, with a male-to-female ratio of 10:1. But more contemporary studies have shown that WT had a similar incidence in female and male, with a 1:1 ratio [7,9]. This change is likely largely due to the increased prevalence of smoking in women in the past few decades.

  • An unexpected Warthin's tumor

    2015, Annales de Pathologie
  • Immunoglobulin class switching to IgG4 in Warthin tumor and analysis of serum IgG4 levels and IgG4-positive plasma cells in the tumor

    2014, Human Pathology
    Citation Excerpt :

    Although the epithelial component is generally believed to represent the neoplastic proliferation of salivary ducts, Honda et al [2] showed, using HUMARA (human androgen receptor gene) analysis, that the epithelial component of Warthin tumor was a polyclonal population, which indicates that Warthin tumor is a nonneoplastic lesion. Previous studies have shown that immune and inflammatory reactions [3] and lymphocytic infiltration [4] may occur in Warthin tumor, although whether and how B-cell immunity is related to the formation of the lymphoid component remains to be fully elucidated. Recently, we and others reported cases that revealed the infiltration of immunoglobulin (Ig)G4-positive plasma cells in Warthin tumor, which implied the possible relationship with IgG4-related disease (IgG4-RD) [5,6].

  • Salivary and lacrimal glands

    2009, Diagnostic Surgical Pathology of the Head and Neck: Expert Consult - Online and Print
View all citing articles on Scopus
View full text